The Chaney Foundation Scholarship
P.O. Box 548, Waldorf, MD 20604
301-932-5665
Applications due: April 30, 2010
The Chaney Foundation has established a tuition assistance program in Charles, Calvert, St. Mary’s or
Caroline Counties, Maryland, for the purpose of furthering a student in a major related to the building
trades. One scholarship in the amount of 1,000.00 (up to a maximum of $4,000.00 over four years) will be
awarded on a competitive basis with preference given to students majoring in a related field such as
Drafting, Construction Management, Concrete Industry Management, Engineering, Environmental
Science, Architecture or Business. This scholarship may be used at the accredited two- or four-year
college of the student’s choice.
A recipient of tuition assistance shall:
 be a student in building/drafting design/construction management/engineering at a high
school in Charles, Calvert, St. Mary’s or Caroline County, Maryland;
 be a resident of Charles, Calvert, St. Mary’s or Caroline County;
 be a graduating senior or have a high school diploma and be enrolled in, or sign a letter
of intent to enroll as a full time student in, a two- or four-year college;
 be selected on a competitive basis in each year that an award is given as set forth on the
application form.
Additional Guidelines:
 The awarded scholarship shall be used for tuition and books only, and will be directly
paid to the college/university.
 Receipt of this tuition assistance award, coupled with other awards, scholarships and
grants, shall not exceed the combined cost of tuition, books and related expenses. If it
does, the amount of this award shall be reduced.
 Application forms are to be received by April 30, 2010 for the following school year.
 Students who have received a grant, maintained a grade point average of 3.0 on a 4.0
scale, and advanced in academic standing at least one year in each year in which
an award is renewed while attending college, may reapply on an annual basis for
additional grants.
 If the recipient fails to maintain at least a 3.0 grade point average and fails to advance
at least one year in each year in which an award is renewed, he/she shall be
ineligible for consideration for further assistance under the program until these conditions
have been met.
 The Applicant shall sign a statement agreeing to abide by the established conditions of
the scholarship concerning grades, etc. If the applicant is under 18 years of age, parents
or guardians shall be required to sign the statement.
I have read the above guidelines of the Chaney Foundation and agree to abide by them.
Date:______________________ Signature:________________________________
Date:______________________ Signature:________________________________
(Parent/Guardian of Minor Applicant)
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The Chaney Foundation Scholarship
P.O. Box 548, Waldorf, MD 20604
301-932-5665
Applications due: April 30, 2010
Scholarship Application
All information on this application form will be considered confidential by the Chaney
Foundation Scholarship Committee. Please answer all questions.
A. Personal Information:
Student’s Full Name___________________________________________________
Mailing Address ______________________________________________________
County _____________________________________________________________
Phone Number (please indicate as cell or land) ______________________________
Social Security No.:__________________ Date of Birth ________________________
NOTE: If you are a direct descendant or custodial child of a Chaney Enterprises’ employee,
retiree, officer or director, you are not eligible for this scholarship; please call (301) 932-5665 for
information on the Leo Curtis Scholarship which was established to aid children of Chaney
Enterprises’ employees.
Parent(s) or Guardian(s) Name ____________________________________________
Parent(s) or Guardian(s) Telephone Number __________________________________
High School Name ______________________________________________________
Senior Awards Night Date ________________________________________________
Class Standing __________ Current SAT Scores __________ ACT Scores ________
Academic Honors Received _______________________________________________
______________________________________________________________________
______________________________________________________________________
Which colleges have you made application to?_________________________________
______________________________________________________________________
Which colleges have notified you of acceptance?
______________________________________________________________________
______________________________________________________________________
What is your planned major in college? ______________________________________
When do you plan to begin pursuing this degree? ______________________________
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The Chaney Foundation Scholarship
P.O. Box 548, Waldorf, MD 20604
301-932-5665
Applications due: April 30, 2010
Have you applied for, or been awarded, any other scholarship(s)? _________________
If yes, please list name and amount of those scholarship(s).
______________________________________________________________________
List extracurricular activities and honors received at school.
______________________________________________________________________
______________________________________________________________________
What are your community, civic, or church involvements?
______________________________________________________________________
______________________________________________________________________
What are your hobbies, interests, or special talents?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
B. Asset Information: (Give the amounts in the following accounts):
Student Parents Total
Saving:
Savings Bonds
for College:
529 Savings Plan
for College:
Checking:
Other:
TOTAL:
C. Parent/Guardian Income Information:
Father’s Occupation___________________ Salary $__________________
Mother’s Occupation__________________ Salary $__________________
Other Family Income (Retirement, etc.) $__________________
Total Family Income $__________________
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The Chaney Foundation Scholarship
P.O. Box 548, Waldorf, MD 20604
301-932-5665
Applications due: April 30, 2010
Parent/Guardian: List Dependents. If dependents are presently enrolled in institutions for
which you pay tuition, give the cost of tuition. (Include yourself.)
NAME AGE GRADE IN YEAR IN RELATIONSHIP ANNUAL
SCHOOL COLLEGE TUITION
Jane Doe 12 7 Daughter $1,000
D. Required Documents (Applications missing any of these documents will be
considered incomplete and ineligible for review)
Please remember to attach the following documents to this application:
1. A 300-word or less essay describing your education and career goals
2. Two (2) letters of recommendation
3. Copy of photo identification
4. Letter(s) of acceptance if not currently attending college
5. Copy of your high school transcript OR most recent college transcript show your current and
cumulative GPA.
As an applicant for a scholarship from the Chaney Foundation, I hereby certify that the
information provided in this application is accurate and complete to the best of my knowledge.
I realize that this information may be verified at a later time by the Scholarship Awards
Committee. In addition, all information requested must be supplied to the committee.
Student Signature ___________________________________________________________
As a parent or guardian of a student who is applying for a scholarship from the Chaney
Foundation, I have completed this form to the best of my knowledge. If asked by an authorized
official, I agree to give proof of the information that I have given on this form. I realize that this
proof may include a copy of my latest federal tax return.
Parent/Guardian Signature __________________________________________________
Applicants for the Chaney Foundation scholarship shall be considered without regard to race, creed,
color, gender, religion, age, national origin, marital status, physical or mental disabilities or veteran’s
status.
Applications are due April 30, 2010. Please return the application and required documents to
The Chaney Foundation, P.O. Box 548, Waldorf, MD 20604-0548, or by e-mail to
For information, please contact Sherry Santana, Community Relations Specialist, 301-932-5665.
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